非手术椎间盘突出患者自我管理行为与自我保健技能现状分析

Analysis of Self-Management Behavior and Self-Care Skills in Patients With Lambardischerniation

目的分析非手术椎间盘突出(lambardischerniation,LDH)患者自我管理行为与自我保健技能现状,为其自我管理能力及自我保健技能干预提供方向。方法调查对象为2018-01/04在上海中医药大学附属曙光医院门诊就诊的非手术LDH患者,采用慢性疾病患者自我管理行为量表、自我保健技能问卷对符合纳入排除标准患者进行自我管理行为与自我保健技能调查并进行统计学描述。结果 269例LDH患者运动锻炼时长及认知症状管理实践、与医生的沟通维度分值分别为(190.98±146.90)min/周、(1.94±1.42)分、(1.82±1.33)分;95.17%的患者以散步为运动锻炼方式,91.82%的患者表示会告诉自己乐观,97.03%的患者表示会向医生咨询治疗问题;所有患者各项自我保健技能掌握比重均不足50%;保健技能训练意义知晓比重仅飞燕展翅一项超50%,为52.79%;且非手术LDH患者症状严重程度与体能锻炼、耐力锻炼时间及认知症状管理、与医生的沟通、自我保健技能评分显著正相关(r=0.312、0.392、0.338、0.345和0.338,P均<0.01)。结论 LDH具较高的自我管理行为评分,但日常自我管理技能及自我保健技能水平较低,且症状严重程度与自我管理行为、自我保健技能水平密切相关性,临床应加强LDH患者日常生活自我管理能力及相关保健技能知识宣教,积极开展专项培训,提升LDH患者自我管理行为及保健技能。

Objective To analyze the self-management behavior and self-care skills of patients with lambardischerniation(LDH) and provide direction for self-management ability and self-care skills intervention. Methods The respondents were nonsurgical LDH outpatients admitted to Shuguang Hospital from January 2018 to April 2018. The self-administration behavior scale of chronic diseases patients and self-care skills questionnaire were performed to investigate self-management behaviors and self-care skills for patients meeting the inclusion and exclusion criteria. Results Of the 269 LDH patients, the exercise duration, values of cognitive symptom management practices and communication dimension with doctors were(190.98 ± 146.90) min/week,(1.94 ± 1.42) points and(1.82 ± 1.33) points, respectively.Generally,95.17% of the LDH patients took walking as the regular exercise,91.82% of all would convinced them be optimistic, and 97.03% reported they would consult the doctor about the treatment. The proportion of patients mastering all self-caring skills was less than 50%. In terms of the awareness for health-care skills training significance, only the proportion of ‘flying swallows’ was more than 50%(52.79%). Conclusion LDH patients show relatively higher scores of selfmanagement behavior. But the daily self-management skills and self-care skills are relatively lower.Clinically, and the severity of symptoms is closely related to patients’ self-management behavior and self-care skills. The hospital should strengthen the health education about daily life selfmanagement ability and related health skills knowledge for the LDH patients and carry out the special training to improve self-management behavior and self-care skills of LDH patients.